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首页> 外文期刊>BMC Pediatrics >Trends in diagnostic approaches for pediatric appendicitis: nationwide population-based study
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Trends in diagnostic approaches for pediatric appendicitis: nationwide population-based study

机译：儿科阑尾炎诊断方法的趋势：全国范围的人口研究

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To define the benefits of different methods for diagnosis of pediatric appendicitis in Taiwan, a nationwide cohort study was used for analysis. We identified 44,529 patients under 18?years old who had been hospitalized with a diagnosis of acute appendicitis between 2003 and 2012. We analyzed the percentages of cases in which ultrasound (US) and/or computed tomography (CT) were performed and non-perforated and perforated appendicitis were diagnosed for each year. Multivariate logistic regression analyses were performed to evaluate risk factors for perforated appendicitis. There were more cases of non-perforated appendicitis (N?=?32,491) than perforated appendicitis (N?=?12,038). The rate of non-perforated cases decreased from 0.068% in 2003 to 0.049% in 2012; perforated cases remained relatively stable at 0.024%~0.023% from 2003 to 2012. The percentage of CT evaluation increased from 3% in 2003 to 20% in 2012; the rates of US or both US and CT evaluations were similar annually. The percentage of neither CT nor US evaluation gradually decreased from 97% in 2003, to 79% in 2012. The odds ratios of a perforated appendix for those patients diagnosed by US, CT, or both US and CT were 1.227 (95% confidence interval (CI) 0.91, 1.65; p?=?0.173), 2.744 (95% CI 2.55, 2.95; p?
机译：为了定义不同方法诊断台湾小儿阑尾炎的益处，全国范围的队列研究用于分析。我们确定了44,529名未满18岁的患者，已住院，诊断为2003年至2012年之间的急性阑尾炎。我们分析了超声（美国）和/或计算断层扫描（CT）的病例百分比和非穿孔的百分比每年诊断穿孔的阑尾炎。进行多元逻辑回归分析以评估穿孔阑尾炎的危险因素。多于穿孔的阑尾炎（N？= 32,491）的更多情况（n？= 12,038）。非穿孔病例的速度从2003年的0.068％下降到2012年的0.049％;从2003年至2012年，穿孔案例保持相对稳定的0.024％〜0.023％。CT评估的百分比从2003年的3％增加到2012年的20％;美国或美国和CT评估的利率每年都有相似。 2003年的CT和美国评估的百分比逐渐减少到2012年的97％至79％。由美国，CT或US和CT诊断的那些患者的穿孔附录的多数比率为1.227（95％置信区间（CI）0.91,1.65; p？= 0.173），2.744（95％CI 2.55,2.95; p？0.001）和5.062（95％CI？= 3.14,8.17; P？<0.001），相比，与没有收到我们或CT的患者相比。对于那些7-12患者的穿孔附录的奇数比例为1.756（95％CI 1.67,1.84; p？0.001）和3.094（95％CI 2.87,3.34; p？0.001 ）分别与那些13-18岁相比。我们的研究表明，使用CT扫描作为急性阑尾炎的诊断工具每年增加;大多数患者尤其是那些接受CT评估的岁月的患者患有穿孔性阑尾炎的风险更大。我们建议在那些儿科患者中提示阑尾切除术，典型的临床症状和用于非复杂性阑尾炎的物理发现，以避免阑尾穿孔的风险。

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